# SPRINGHILL DERMATOLOGY CLINIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144420936
- **Authorized official:** DR. BELEN FRED BODIE MD (OWNER)
- **Authorized official phone:** (251) 342-7880

## Contact information

- **Practice address:** 4300 OLD SHELL RD STE B, MOBILE, AL 36608-2036
- **Practice address phone:** (251) 342-7880
- **Practice address fax:** (251) 342-8369
- **Mailing address:** 4300 OLD SHELL RD STE B, MOBILE, AL 36608-2036
- **Mailing address phone:** (251) 342-7880
- **Mailing address fax:** (251) 342-8369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | 6998 | AL | Yes |

## Other

- **Enumeration date:** 07/20/2007
- **Last updated:** 07/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 51004869 | BLUE CROSS AND BLUE SHIELD | AL |
| 01 | — | CG4447 | MEDICARE RAILROAD | AL |